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Interacting With Drug Labels

How to use prescription drug information for a safer and healthier experience

WEDNESDAY, June 12 , 2002 (HealthDayNews) -- Used to be you could barely read, let alone understand, what your doctor had scrawled across that prescription pad. So, you'd take that scribbled note from physician to pharmacist and then willingly gobble down the medicine with little more information than what appeared on the instruction label.

Not any more. In fact, most of today's health consumers are well-versed on information about the drugs their doctors prescribe, sometimes long before they even get that prescription in their hands.

"You almost can't open a newspaper or a magazine, or even turn on the TV, without seeing a prescription drug commercial -- with information that, until just a few years ago, was available only to doctors and pharmacists," says Vincent Giambanco, the director of pharmacy at the Jewish Home and Hospital in New York City.

Add to this Web sites, patient-information guides, drug inserts, pill guides, even a consumer version of the professional medical PDR -- Physicians Desk Reference -- and experts say patients now have the potential to learn as much about a medication as doctors know.

But although an educated consumer is a healthier patient, experts say there can also be too much of a good thing. This is often the case when the information created to help you use medications more wisely ends up scaring or confusing you -- sometimes to the point where you don't even take the medicine at all.

"Patients will sometimes look at what they perceive to be a long, scary list of side effects or adverse effects, and they begin to wonder if the cure isn't worse than the disease," Giambanco says.

According to the Council on Family Health, the key to using drug information as wisely as you use the drug itself is to become familiar with the terminology used to explain how medications work.

Among the most important of those terms is "side effects."

"A side effect is a pharmacological activity that is both use- and dose-dependant," says Bob Donovan, president of the Council on Family Health. So, says Donovan, the kind of reaction you get is often determined by how much of the drug you take and what you are taking it for.

And although the list of side effects for some drugs can seem daunting, it's important to remember they are presented in descending order. Much like the label on your favorite box of cookies -- where the first ingredient is more plentiful than the last -- the side effects mentioned first are the most common, while those at the end of the list are least likely to occur.

"Examples of common side effects include things like nausea, dizziness, sleepiness -- problems that usually go away after a short time and don't normally pose any real health threats," Giambanco says.

In addition, most drug companies further categorize side effects as common, uncommon and rare. But what does this really mean?

"Problems that are listed as common generally occur once in every 10,000 users; problems listed as uncommon can develop in one out of every 100,000 users; effects listed as rare are thought to be around one in 1,000,000 users," Donovan says.

The reason the list you see is so long: "Manufacturers have a responsibility to enumerate all the potential side effects [noted throughout the lifetime of the drug], but consumers' angst could be relieved if they could view those side effects in the proper range context," says Donovan.

Also important: Recognizing the difference between the various types of effects caused by a drug and the circumstances under which they normally occur.

A side effect, for example, is a somewhat expected reaction, so it's more likely to occur for larger numbers of people, says Giambanco.

By comparison, an adverse effect is when "something that is happening diminishes the efficacy of the product," says Donovan. An "adverse event," he says is "something that generally occurs that may or may not have been the result of the drug."

Experts say both adverse effects and adverse events happen far less frequently than side effects.

If you're looking to find out when a drug might not be right for you, the section you want to read is called "contraindications."

"If a drug is contraindicated, it means it may cause problems for a specific group of users, such as pregnant women or breast-feeding mothers," says Giambanco.

If you don't fall into the specific group mentioned in this section, Giambanco adds, then the problems listed won't apply to you.

If the risk of an allergic reaction is of primary concern, check for indications under the headings marked "side effects" and "warnings", where extremely important data is usually highlighted in a black box.

"The black box also features the risk of serious adverse reactions, such as organ damage or death," says Donovan.

Again, it's important to remember that "warnings" describe events that are extremely rare -- and highly unlikely to occur in the general population, says Giambanco.

The bottom line, say experts, is to use whatever information you learn about a medication to open a dialogue with your doctor or pharmacist -- and then consider their advice the last word on safety and effectiveness.

What To Do

To learn even more about the terms used to define prescription drug reactions, click here for a specially prepared glossary.

For more information about how to use prescription drugs safely, visit the Council on Family Health.

You can also find important information on how drugs interact with herbal preparations and other natural treatments by visiting the The American Academy of Family Physicians.

SOURCES: Vincent Giambanco, Director of Pharmacy, Jewish Home and Hospital, New York City; Bob Donovan, president, Council on Family Health; "How To Read Prescribing Information," Hoechst Marion Roussel Pharmaceuticals, Kansas City
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